Individual
MRS. NICOLE ALEXIS GEORGIEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
7 CORNFIELD LN, COMMACK, NY 11725-2701
(631) 655-6187
Mailing address
7 CORNFIELD LN, COMMACK, NY 11725-2701
(631) 655-6187
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86358043
NY
Other
Enumeration date
01/04/2025
Last updated
01/14/2025
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